Theory-based evaluation of three research–practice partnerships designed to deliver novel, sustainable collaborations between adult social care research and practice in the UK: a research protocol for a ‘layered’ contributions analysis and realist evaluation

Introduction Research–practice partnerships (RPPs) are long-term collaborations between research and practice that aim to conduct research that can be used to make practice-based improvements. They intentionally bring together diverse experience in decision making and seek to shift power dynamics so that all partners have a say. The Creating Care Partnerships project aims to explore whether the RPP approach developed within the US educational context can be successfully applied to the English care home context. The project involves a programme of codesign, implementation and evaluation within three case study sites. This protocol set outs the aims, research design and governance of the evaluation. Methods and analysis The evaluation takes a theory-based approach to explore how, why and in what circumstances RPPs in the care home context contribute to enhancing research and research use in local care homes and informing wider improvement efforts. A mixed-methods design will be used for each case study, including semistructured interviews, observations of RPP events and meetings, an online survey, activity diary and review of local data and documents. Data collection will proceed in waves, with the theory of change (ToC) being continually refined and used to guide further data collection and analysis. Insights will be drawn using Contribution Analysis, Realist Evaluation and systems perspectives to assess the contribution made by the case study sites to achieving outcomes and the influence of contextual factors. Economic consequences will be identified through the ToC, using a narrative economic analysis to assess costs, consequences and value for money. Ethics and dissemination The study has undergone ethics review by HRA Research Ethics Committee. It does not pose major ethical issues. A final report will be published and articles will be submitted to international journals.

2. Do you have any questions about the wider study or about the interview we will be conducting today?
3. If you are happy to please can you sign the consent form that I sent you and email it back to me for our records. The consent form is a standard form used in social research and is used to ensure that: • you understand the aims of the study • you understand what your participation in the study will involve • you are happy for the discussion to be audio recorded • you know that you can change your mind about taking part in the study at any timeyou can request for the discussion to stop at any time and if at any point you want to withdraw from the study you can request this by using the contact information provided to you today • you know that your views will be kept confidential and your name will never be used in anything that is written about the study • you consent to take part. 2. How does your university relate to other organisations/universities in the region? Does it have a strategy with respect to how it works with organisations in its region? Is the university involved in any major regional cross-sector partnerships, e.g. ARCs?
Care Home/local authority/third sector interviewees 2. Can you describe how the partners came together to start the [name of partnership] and respond to the EOI? Probe around understanding the initial power dynamics: • Whether one person or partner took the lead and brought all the partners together or whether partners / people were suggested by different members • Whether they came together at all, had meetings over the phone, who was involved in the decisions and writing the EOI. • Whether they discussed resources and how those would be held and parcelled out. • Whether they discussed a structure for the management and organisation of the partnership, what roles people would have • Whether they discussed what they wanted to achieve and how they would achieve it • Whether they discussed ways of working BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s)

D. Perspectives of the partnership member on their role and the partnership
The aim of this section is to explore the personal motivations for participating in [name of partnership], understand the relationships in the partnership and the member's role and capacity to fulfil that role in the partnership.

i) Reasons for participation in the partnership
1. Can you tell me about why you personally wanted to participate in the [name of partnership]?

ii) Experience of research-practice partnership working and relationships between members (previous and existing)
The aim of this section is to collect data on the their views about the potential for research to inform and improve practice, the relationships between partnership members and how these evolve over the course of the partnership. In early interviews we will ask about the formation of relationships prior to the official start of the partnership, but in later interviews we will look at how perceptions of partners are changing.
The issues to dig into are the shifting power dynamics as the partnership progresses, in what respects different partners hold power, and how has it been relinquished, contested, and held onto. We also want to explore the cycles of relationship building, maintenance, breakdown and repair as the partnership progresses and how these feed into future partnership work.
3. Before you started/joined this partnership how familiar were you were working in partnerships with other organisations to produce research for practice improvement? What view did you have about the potential for research to inform improvements in practice? Do you think your previous experience has had an influence on how you have approached this partnership? Note: for academic partners we are interested in understanding about their experience of previously working with partners from practice around research Probe around: • What your previous experiences were like and what you learnt from those previous experiences, focus on experiences or research / experience of working with practitioners to co-produce research The aim of this section is to explore the way in which individual's capacity to conduct partnership work has built up over time.
In the early stages we will concentrate more on the pre-existing skills, capacities and knowledge of partners before moving on to look at the types of individual dispositions, skills and capacities that were needed to engage in partnership work and whether their previous experiences enabled or inhibited this. In the later stages we will concentrate on how skills and capabilities for conducting research and joint working developed over time and the influence of the partnership members and infrastructure, wider networks and resources. • Particular knowledge that helps, e.g. learning about each other's org culture • Particular skills that help or know-how, e.g. experience merging or balancing these perspectives and skills • Relationships and developing a common language, purpose etc • Other people being key, e.g. new roles crossing over org boundaries • Infrastructure being key, e.g. meetings/forums for collaborating • Support being key, e.g. training, mentoring, activities of CCP team E. Developing and delivering the partnership: strategic and operational aspects The aim of this section is to explore the ways in which the partnership is developing. This includes the initial setup, building trust and relationships, and individual level and partnership capabilities.

i) Understanding of the RPP approach and the current strategy for implementing it
The purpose of this section is to capture how the RPP approach is understood, and the goals and priorities for partnerships. It will be important to understand how the work programme is negotiated and agreed and changes as the partnerships develops.
Questions around understanding of the RPP approach and goals are for everyone but the strategy question is just for leadership / those involved in the decision-making • How this has changed over time • Whether these goals are reflected in a strategy document or have emerged from strategic discussions • If there is a strategy document then ask for it if not already seen • What the reasons were for choosing these goals, e.g. unmet need, influence of policy / economic context, influence of key stakeholders etc • Whose interests were reflected in the goals, how they were negotiated 3. Do you have a main focus of work for [name of partnership] for the short term (e.g. next 6 months or so)? Can you talk me through the process through which your partnership decided on this focus/foci for the work? Probe around • Who was involved in the decision making?
• Why this focus was chosen over others, e.g. gap/problem identified, other aspects contingent on this, quick win, advocated by a particular partner, met the needs of a particular stakeholder, influence of university or senior management at provider, or other external players? • Whether there were any differences in opinion and what they were about, how they were resolved • If there is more than one focus then explore how this is managed? • Try to get them to focus on aspects other than the research agenda, e.g. communications about partnership or more generally, capacity-building of staff, building relationships and trust, participation/addressing inequalities of power, bringing in missing voices ii) Understanding how the partnership's plans will be delivered: structure, organisation and resources within the partnership The purpose of this section is to capture how the RPP approach is being delivered, whether there is a plan and overarching framework/structure for delivery, whether people have specific roles, what activities are being carried out, by whom and with what resources. It will be important to understand how the partners contribute to explore the degree of participation and power relationships. We will also want to track how the goals and priorities for partnerships change as the partnership develops.
This does not need to be asked of everyone; mainly for leaders 1. Can you describe the plan for how you will deliver the partnership's work programme? • Explore peoplewho is involved and which organisation they come from • Explore finance and where the money is coming from (e.g. CCP grant, partners own budgets, other sources) • Any other resources that need to be brought in, e.g. software/technical expertise, website etc

iii) Understanding the capacity of the partnership to deliver the work programme and intentions to build capacity
The aim of this section is to explore the way in which organisational capacity to conduct partnership work has built up over time.
The issues and themes to dig into are around whether the partnership has the right membership composition in term of skills and knowledge, whether the partnership feels cohesive and members identity with it are the individual level capabilities needed, the types of capabilities needed by different partners and how these are balanced. We are also interested in the relationship between individual level capabilities and the building of partnership level capabilities that can lead to a functioning and sustainable entity. This section explores the way in which research is being done and used by the partnership and the impact the partnership's research is having on practice more broadly. Key aspects to explore are power dynamics, the degree of participation in all aspects of the research by partnership members and how these activities are being supported by the partnership and routinised.

Stakeholder interview proforma
This proforma will be used for stakeholders connected to the three case study partnership sites. Stakeholders include anyone who has had influence over strategic direction and operations of one the partnership or is part of an organisation that has interest and could be directly influenced by partnership work. This could include university leadership, local authority leaders or commissioners, social workers, directors of care homes, local trade associations, CQC inspectors, local Applied Research Collaborations (ARCs) or other research collaborations, Enabling Research in Care Homes (ENRICH) members, or Clinical Research Networks. We need to adapt the proforma based on who we are speaking to, as not all of these questions will be relevant to all interviewees. As issues emerge, we may need to add questions in to ensure all relevant issues are covered.
The aim of the stakeholder interviews is to explore the way in which those external to the partnership but with a vested interest interact, use, and value the RPP. In the early-stage interviews, we will focus on gaining insight into the types of organisations and key people who have an interest or strategic oversight of the operations of the partnership and contextual factors relating to their organisation and networks. Early interviews will also seek to gain insight on the level awareness and communication they have of partnership work.
In later interviews, we will look to explore more directly how stakeholders are making sense of partnership goals and research outputs, whether research is useful and useable, and whether the partnership is valuable from an external perspective.

J. Introductory information
My name is XXXXXX. Thank you for agreeing to take part in the Creating Care Partnerships (CCP) study.
We are interviewing stakeholders from the [name of partnership] lead to get a better understanding of your experiences of working with [name of partnership]. The interview should last an hour. During the interview, I will ask you about your level of involvement with the partnership, how you use and value the work produced by the partnership, and external events and local conditions influencing how the partnership works and its ability to achieve its goals. I am sure there will be some areas you have more knowledge about. Where there are gaps in your knowledge it would be helpful if you could identify people or key documents that may help us to better understand the way your organisation works with the [name of partnership].

Informed Consent
BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s) 5. Do you have any questions about the wider study or about the interview we will be conducting today?
6. If you are happy to please can you sign the consent form that I sent you and email it back to me for our records. The consent form is a standard form used in social research and is used to ensure that: • you understand the aims of the study • you understand what your participation in the study will involve • you are happy for the discussion to be audio recorded • you know that you can change your mind about taking part in the study at any timeyou can request for the discussion to stop at any time and if at any point you want to withdraw from the study you can request this by using the contact information provided to you today • you know that your views will be kept confidential and your name will never be used in anything that is written about the study • you consent to take part.

[Note: if the participant is not able to sign and return the consent form then consent can be recorded orally.]
[Start recording] Software will request participant to give permission to start recording. If face-to-face then request permission to start recording

K. Introductory questions
The aim of this section is to gain some contextual information about the stakeholder and their organisation, as well as the relationship between themselves/their organisation and the [name of partnership].

Can you tell me about your current professional role at [name of organisation]
and how long you have been in post? • What they think might be barriers in the wider system • What they think might help the partnership • How well it fits in the system, its potential for social care and the production and use of evidence to inform and improve practice

M. Interaction with the [name of partnership]
The aim of this section is to understand more about the ways in which stakeholders are engaging within the [name of partnership]. If they are using the research then we will explore whether they are able to access and make sense of research findings and how this could be improved.

Co-design team interview proforma
This proforma will be used for members of the co-design team within the Creating Care Partnerships (CCP) project.

P. Introductory information
My name is XXXXXX. Thank you for agreeing to take part in the Creating Care Partnerships (CCP) study.
We are interviewing members of the codesign team to get a better understanding of the role of the co-design team within the CCP project, how your view of the RPP approach has changed over time and the support you gave to the three partnership sites.
The interview should last an hour. During the interview I will ask you about your role within the co-design team, what types of events and activities were held for the first phase of codesign and how this informed your work going forward with the sites. I will also ask you about your work with the sites, the principles you employed, and your reflections on how the sites were working to build their partnership. I am sure there will be some areas you have more knowledge about. Where there are gaps in your knowledge it would be helpful if you could identify people or key documents that may help us to better understand the role of the co-design element of the project in supporting the sites to develop their partnerships.

Can I just check that you received the study information sheet and that you
have had a chance to read it?
No -[Review the study information sheet in detail] Yes -Good [Review the study information sheet briefly] 8. Do you have any questions about the wider study or about the interview we will be conducting today?
9. If you are happy to please can you sign the consent form that I sent you and email it back to me for our records. The consent form is a standard form used in social research and is used to ensure that: • you understand the aims of the study • you understand what your participation in the study will involve • you are happy for the discussion to be audio recorded • you know that you can change your mind about taking part in the study at any timeyou can request for the discussion to stop at any time and if at any point you want to withdraw from the study you can request this by using the contact information provided to you today BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s)
• you know that your views will be kept confidential and your name will never be used in anything that is written about the study • you consent to take part.
[Note: if the participant is not able to sign and return the consent form then consent can be recorded orally.] [Start recording] Software will request participant to give permission to start recording. If face-to-face then request permission to start recording

Q. Introductory questions about co-design team members and the role of co-design in the CCP project
The aim of this section is to gain some contextual information about the co-design team member's role in relation to the Creating Care Partnerships (CCP) project.
6. Can you tell me about your current professional role at [name of organisation] and how long you have been in post?
How were you first introduced to the RPP approach? First thoughts and impressions • Can you tell me in your own words what the RPP approach is and what it is trying to achieve?
• Can you tell me in your own words what the role of co-design is in the CCP project?
Explore around: • Your role in relation to the overall aims of the project • Your role in relation to the other CCP project teams, i.e. implementation, evaluation, spread and sustainability, lived experience reference group • Your role in relation to the three sites that are implementing the RPP approach • Any differences in how you have approached and carried out co-design in the CCP project compared to other projects, e.g. steps/method, aims/goals, outputs

R. First phase of co-design
The aim of this section to explore the types of activities taking place in the first phase of co-design work, what was learnt about the RPP approach from this phase, and how this learning fed into the co-design work with the case study sites.
1. Can you describe the main aims of the first phase of co-design? 2. Can you describe the process of taking the insights from the co-design activities to develop an RPP approach that is suitable for the English care home context? Explore around: • How you balanced pre-existing knowledge/insights from the literature with stakeholder insight • How your thinking changed about what the RPP approach is 3. How do you think implementing the RPP approach will play out in the sites?
How will it be influenced by or influence elements of social care/HEI context? What kinds of challenges will the sites face? Do you think any elements of the RPP approach will be more achievable? Note: discuss social care and HEI context separately Explore around different levels of the system: Explore around the influence in relation to the following areas: • Building trust and relationships within RPPs • Individual skills, knowledge, capacity for engaging in partnership work • Organisational capabilities for doing research for practice improvement • Organisational capabilities for using research for service and system improvement

S. Second phase of co-design
The aim of this section is to explore the types of activities taking place in the second phase of co-design work, what types of support the local sites needed and the challenges of developing RPPs within the local context.
1. Can you describe the main aims of the co-design phase with the sites?
2. Can you describe how you organised the co-design sessions and your decision-making around the structure and content of the different sessions?
Probe around: • What type of co-design activities did you run?
• What principles did you follow during this phase?
• Adapting to time and resources available within the sites, and the attitudes of the sites 3. How have the sites responded to the co-design process and activities? Note: discuss each site separately Probe around: • What challenges did they have/what seemed to come easier? o in relation to the co-design materials and the activities o in relation to their understanding of the RPP approach o in relation to their understanding of how to develop their partnership in a way that is consistent with the RPP approach • How did the different members of the partnership work together and with the co-design team? Any differences in degree of participation? Were some people more vocal? Did people defer to particular members of the partnership?
4. Do you have any sense of how the sites have used/are using the codesign sessions to inform the way they are developing their partnership? Note: discuss each site separately Probe around: • Any feedback from the sites / follow-up • Any indications from discussions in the sessions • Did they bring plans or start planning in the sessions? 5. Did you have any sense of how the site's local context might be influencing their engagement with the co-design work? Note: discuss each site separately Probe around: • What they want to discuss? • Ability to work with the co-design team or together? 6. You have said your approach to working with the sites is to be more facilitative, so the co-design team do not become an extension of the partnership at each site. How has that intention worked in practice?

CCP implementation team interview proforma
This proforma will be used for members of the implementation team within the Creating Care Partnerships (CCP) project.

T. Introductory information
My name is XXXXXX. Thank you for agreeing to take part in the Creating Care Partnerships (CCP) study.
We are interviewing members of the implementation team to get a better understanding of the role of the implementation team within the CCP project and support you have given the sites as they are developing their partnership.
The interview should last an hour. During the interview, I will ask you about your role in the implementation team, how you view the RPP approach and the influence of wider contextual factors on applying this approach within social care. I will also ask you about the activities you have carried out to support the sites and your reflections on how the sites are developing their partnership. I am sure there will be some areas you have more knowledge about. Where there are gaps in your knowledge it would be helpful if you could identify people or key documents that may help us to better understand the implementation element of the project.

Informed Consent
10. Can I just check that you received the study information sheet and that you have had a chance to read it?
No -[Review the study information sheet in detail] Yes -Good [Review the study information sheet briefly] 11. Do you have any questions about the wider study or about the interview we will be conducting today?
12. If you are happy to please can you sign the consent form that I sent you and email it back to me for our records. The consent form is a standard form used in social research and is used to ensure that: • you understand the aims of the study • you understand what your participation in the study will involve • you are happy for the discussion to be audio recorded • you know that you can change your mind about taking part in the study at any timeyou can request for the discussion to stop at any time and if at any point you want to withdraw from the study you can request this by using the contact information provided to you today • you know that your views will be kept confidential and your name will never be used in anything that is written about the study • you consent to take part.
[Note: if the participant is not able to sign and return the consent form then consent can be recorded orally.] [Start recording] Software will request participant to give permission to start recording. If face-to-face then request permission to start recording

U. Introductory questions about co-design team members and the role of implementation team in the CCP project
The aim of this section is to gain some contextual information about the implementation team member's role in relation to the Creating Care Partnerships (CCP) project. It is also to gain an understanding of how the implementation team view the RPP approach and the ways it will relate to the social care/HEI context. Explore around the influence in relation to the following areas: • Building trust and relationships within RPPs • Individual skills, knowledge, capacity for engaging in partnership work • Organisational capabilities for doing research for practice improvement • Organisational capabilities for using research for service and system improvement

C. Main activities and ways of working with the sites
The aim of this section is to explore the types of activities that the implementation team are engaged in to support the sites, the main challenges, and the impact.

D. Reflections on how the partnerships are working in practice
The aim of this section is to understand how the implementation team perceive the way in which partnership sites are working together, their ability to assess their own needs, and how contextual factors may be influencing their success.

Lived experience lead interview proforma
This proforma will be used for the Lived Experience Reference Group (LERG) of the Creating Care Partnerships (CCP) project.

V. Introductory information
My name is XXXXXX. Thank you for agreeing to take part in the Creating Care Partnerships (CCP) study.
We are interviewing the lived experience reference group lead to get a better understanding of the role of the lived experience reference group within the CCP project and the support the group has given the sites as they are developing their partnership.
The interview should last an hour. During the interview, I will ask you about the role of the lived experience reference group, how you view the RPP approach and the influence of wider contextual factors on applying this approach within social care. I will also ask you about the activities the group has carried out to support the CCP sites and your reflections on how the sites are developing their partnership. I am sure there will be some areas you have more knowledge about. Where there are gaps in your knowledge it would be helpful if you could identify people or key documents that may help us to better understand the lived experience element of the project.

Informed Consent
13. Can I just check that you received the study information sheet and that you have had a chance to read it?
No -[Review the study information sheet in detail] Yes -Good [Review the study information sheet briefly] 14. Do you have any questions about the wider study or about the interview we will be conducting today?
15. If you are happy to please can you sign the consent form that I sent you and email it back to me for our records. The consent form is a standard form used in social research and is used to ensure that: • you understand the aims of the study • you understand what your participation in the study will involve • you are happy for the discussion to be audio recorded • you know that you can change your mind about taking part in the study at any timeyou can request for the discussion to stop at any time and if at any BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s) point you want to withdraw from the study you can request this by using the contact information provided to you today • you know that your views will be kept confidential and your name will never be used in anything that is written about the study • you consent to take part.
[Note: if the participant is not able to sign and return the consent form then consent can be recorded orally.] [Start recording] Software will request participant to give permission to start recording. If face-to-face then request permission to start recording

W. Introductory questions about the lived experience reference group and the role of the group in the CCP project
The aim of this section is to gain some contextual information about the LERG's role in relation to the Creating Care Partnerships (CCP) project. It is also to gain an understanding of how the LERG lead views the RPP approach and the ways it will interact with the social care/HEI context.

Can you tell me about your current professional role at [name of organisation]
and how long you have been in post?
6. How were you first introduced to the RPP approach? First thoughts and impressions 7. Can you tell me in your own words what the RPP approach is and what it is trying to achieve? Explore around: • Core principles • Whether your views on this have changed following co-design work 8. Can you tell me in your own words what the role of the lived experience reference group within the CCP project?
Explore around: • How members were recruited and what you were looking for • The group's role in relation to the overall aims of the project • The group's role in relation to the other CCP project teams, i.e. co-design, evaluation, implementation, spread and sustainability • The group's role in relation to the three sites that are implementing the RPP approach • What's not within their remit 9. How do you think implementing the RPP approach will play out in the sites?
How will it be influenced by or influence elements of social care/HEI context? BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s)